allergy anaphylaxis Flashcards
3 most important peds allergies
- food
- drug
- env
patho of allergy
- first time antigen binds to Th2 cell and stim ulates IgE production by B-cells
- get large number of IgE that bind to mast cell and stay
- sencond exposure binds to IgE on mast cell and cause cross-linking - degranulates the mast cell
- mast cell releases histamine and cytokines
effect of histamine and cytokines
histamine - immediate hypersens. - vascular smooth muscle response
cytokines - late phase inflammation
Sx of immediate hypersens (4)
- urticaria (hives)
- wheeze
- rhinitis
- angioedema
what is epi of food allergy in kids
1.5-5% - less common than people think
what is allergic march
kids being developing allergies in sequence as they are exposed to them
what is burden of env. allergies
very high - 6 billion
Sx of env. allergy
- rhinitis
- salute
- wheeze
things to assess on Hx of allergy
- specific of CC
- Sx
- action taken and effect
- viral illness present?
- previous exposures
- previous treatments
- family Hx
physical for allergy
often not symptomatic when seen
- swollen nasal mucosa
- rhinitis, hives, congestion
- signs and Sx of asthma
what does skin prick test
presence of IgE, not necc allergy
what should not be done with SPT
panel
what is SPT good for and bad for
NPV is high
PPV is only 50%
when is intracutanous test used
- penicillin, vaccines, venom
- only after -ve SPT
what is gold standard test for food allergy
food challenge test
what is radioallergenosorbent test
blood test looking for IgE
- SPT is more sensitive
main treatment of allergy
avoidance of the foods
pharma
- epi-pen
other pharma
- anti-histamines
- nasal corticosteroids
- anti-leukotrienes
when is immunotherapy good
for those that have failed all else
general def. of anaphylaxis
compromised or severe involvement of resp andor/hypotension as well as features of skin and GI involvment
triggers of anaphylaxis
- food
- insects
- meds
- exercise
- vaccines
- latex
- immunotherapy
what is possible marker of anaphylaxis and use
serum tryptase
- needs to be taken at time
- only get back a week later
2 course of anaphylaxis
uniphasic - normally
biphasic - can sometimes get second initiation
**acute MGMT of ana
- ABCs
- 0.01cc/kg epi – IM!!
